Abstract
Background. Papillary thyroid cancer (PTC) exhibits a higher incidence in women. Due to various ages at menarche and menopause, estrogen levels vary, which may account for the differences in the occurrence, development, and prognosis of female patients with PTC. Objective. The aim of this study was to investigate the association between various durations in different estrogen levels and PTC and to provide important information to guide clinical management and treatment of this disease. Methods. First, we selected naturally menopausal female study subjects diagnosed with PTC at Zhejiang Cancer Hospital from 2007 to 2012 and then compared the differences in clinicopathological characteristics and prognosis among subjects with various lengths of premenarche, reproductive periods, and postmenopausal stages. Results. We found that all patients showed a significantly higher incidence of tumor multicentricity and intrathyroidal dissemination as the time after menopause increased. Additionally, women with shorter (<30) or longer (>38) reproductive lives had increased recurrence rates of PTC. Conclusions. In this study, we did not find any relationship of self-reported menarche and menopausal ages with the prognosis of PTC patients. More importantly, natural postmenopausal PTC patients with shorter or longer reproductive life, compared to the normal groups, had a higher rate of cancer recurrence and the patients with these characteristics could be recommended a more aggressive surgical treatment.
Highlights
Thyroid cancer is a more predominant malignancy in women than in men [1], which is likely due to the more variable hormonal environments in women than in men [2]
Jonklaas et al [4] found that postmenopausal women diagnosed with papillary thyroid cancer (PTC) had worse outcomes than premenopausal women and suggested that menopauseassociated hormonal alterations may be the cause of this outcome, which was supported by other studies [5, 6]
These data showed that the occurrence, development, and prognosis of Papillary thyroid cancer (PTC) are significantly influenced by the levels of sex hormones during a woman’s life
Summary
Thyroid cancer is a more predominant malignancy in women than in men [1], which is likely due to the more variable hormonal environments in women than in men [2]. Some studies have focused on the role of estrogen receptors and estradiol in PTC, which have suggested that estradiol can stimulate the proliferation of PTC cells [7,8,9] These data showed that the occurrence, development, and prognosis of PTC are significantly influenced by the levels of sex hormones during a woman’s life. We selected naturally menopausal female study subjects diagnosed with PTC at Zhejiang Cancer Hospital from 2007 to 2012 and compared the differences in clinicopathological characteristics and prognosis among subjects with various lengths of premenarche, reproductive periods, and postmenopausal stages. Natural postmenopausal PTC patients with shorter or longer reproductive life, compared to the normal groups, had a higher rate of cancer recurrence and the patients with these characteristics could be recommended a more aggressive surgical treatment
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